ALENDRONIC ACID/CHOLECALCIFEROL WEEKLY BLUEFISH 70 mg/2,800 IU TABLETS

2. What you need to know before you take Alendronic Acid/Cholecalciferol Weekly Bluefish

Do not take Alendronic Acid/Cholecalciferol Weekly Bluefish

• if you are allergic to alendronate sodium trihydrate, cholecalciferol, or any of the other ingredients of this medicine (listed in section 6),
• if you have certain problems in your throat (esophagus - the tube that connects your mouth to your stomach), such as narrowing or difficulty swallowing,
• if you cannot stand or sit upright for at least 30 minutes,
• if your doctor has told you that you have low calcium levels in your blood.

If you think any of these apply to you, do not take the tablets. Consult your doctor before taking this medicine and follow their advice.

Warnings and precautions

Talk to your doctor or pharmacist before taking Alendronic Acid/Cholecalciferol Weekly Bluefish if:

• you have kidney problems,
• you have, or have recently had, swallowing or digestive problems,
• your doctor has told you that you have Barrett's esophagus (a disease associated with changes in the cells that line the lower part of the esophagus),
• you have been told that you have problems absorbing minerals in your stomach or intestines (malabsorption syndrome),
• you have poor dental hygiene, gum disease, a planned dental extraction, or do not receive regular dental care,
• you have cancer,
• you are undergoing chemotherapy or radiotherapy,
• you are taking angiogenesis inhibitors (such as bevacizumab or talidomide), which are used in the treatment of cancer,
• you are taking corticosteroids (such as prednisone or dexamethasone), which are used in the treatment of conditions such as asthma, rheumatoid arthritis, and severe allergies,
• you are or have been a smoker (as this may increase the risk of dental problems).

You may be advised to have a dental check-up before starting treatment with Alendronic Acid/Cholecalciferol Weekly Bluefish.

It is important to maintain good oral hygiene when taking Alendronic Acid/Cholecalciferol Weekly Bluefish. You should have regular dental check-ups during your treatment and should contact your doctor or dentist if you experience any problems in your mouth or teeth, such as tooth loss, pain, or inflammation.

Irritation, inflammation, or ulceration of the throat (esophagus - the tube that connects your mouth to your stomach) may occur, often with symptoms of chest pain, heartburn, difficulty or pain when swallowing, especially if patients do not drink a full glass of water and/or if they lie down before 30 minutes after taking Alendronic Acid/Cholecalciferol Weekly Bluefish. These side effects may worsen if patients continue to take Alendronic Acid/Cholecalciferol Weekly Bluefish after developing these symptoms.

Girls and adolescents

Alendronic Acid/Cholecalciferol Weekly Bluefish should not be given to girls and adolescents under 18 years of age.

Using Alendronic Acid/Cholecalciferol Weekly Bluefish with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Calcium supplements, antacids, and some oral medicines may interfere with the absorption of Alendronic Acid/Cholecalciferol Weekly Bluefish if taken at the same time. Therefore, it is important that you follow the instructions given in section 3 (How to take Alendronic Acid/Cholecalciferol Weekly Bluefish) and wait at least 30 minutes before taking any other medicine or supplement.

Certain medicines for rheumatism or long-term pain, called NSAIDs (such as aspirin or ibuprofen), may cause digestive problems. Therefore, caution should be exercised if these medicines are taken at the same time as Alendronic Acid/Cholecalciferol Weekly Bluefish.

Certain medicines or food additives may prevent the absorption of vitamin D from Alendronic Acid/Cholecalciferol Weekly Bluefish, including artificial fat substitutes, mineral oils, weight loss medication, orlistat, and cholesterol-lowering medicines, cholestyramine, and colestipol. Medicines for epilepsy (seizures) (such as phenytoin or phenobarbital) may decrease the effectiveness of vitamin D.

Individually, the need for additional vitamin D supplements may be considered.

Taking Alendronic Acid/Cholecalciferol Weekly Bluefish with food and drinks

Food and drinks (including mineral water) may reduce the effectiveness of Alendronic Acid/Cholecalciferol Weekly Bluefish if taken at the same time. Therefore, it is important that you follow the advice given in section 3 (How to take Alendronic Acid/Cholecalciferol Weekly Bluefish). You should wait at least 30 minutes before taking any food and drinks except water.

Pregnancy and breastfeeding

Alendronic Acid/Cholecalciferol Weekly Bluefish is only intended for use in postmenopausal women.

Do not take Alendronic Acid/Cholecalciferol Weekly Bluefish if you are or think you may be pregnant, or if you are breastfeeding.

Driving and using machines

Side effects with Alendronic Acid/Cholecalciferol Weekly Bluefish (such as blurred vision, dizziness, and severe bone, muscle, or joint pain) have been reported that may affect your ability to drive or use machines. (See Possible side effects). If you experience any of these side effects, do not drive until you feel better.

Alendronic Acid/Cholecalciferol Weekly Bluefish

This medicine contains lactose and sucrose. If your doctor has told you that you have an intolerance to certain sugars, consult them before taking this medicine.

It may cause cavities.

Alendronic Acid/Cholecalciferol Weekly Bluefish contains sodium

This medicine contains less than 23 mg of sodium (1mmol) per tablet; this is essentially "sodium-free".

3. How to take Alendronic Acid/Cholecalciferol Weekly Bluefish

Follow exactly the administration instructions of this medicine as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Take one tablet of Alendronic Acid/Cholecalciferol Weekly Bluefishonce a week.

Follow these instructions carefully.

1. Choose the day of the week that best suits your routine. Each week, take one tablet of Alendronic Acid/Cholecalciferol Weekly Bluefish on the day you have chosen.

It is very important that you follow instructions 2), 3), 4), and 5) to help the tablet of Alendronic Acid/Cholecalciferol Weekly Bluefish reach your stomach quickly and help reduce possible irritation of the throat (esophagus - the tube that connects your mouth to your stomach).

1. After getting up in the morning and before taking any food, drink, or other medicine, swallow the whole tablet of Alendronic Acid/Cholecalciferol Weekly Bluefish with a full glass of water (not mineral water) (at least 200 mL), so that Alendronic Acid/Cholecalciferol Weekly Bluefish is absorbed properly.
   • Do not take it with mineral water (with or without gas).
   • Do not take it with coffee or tea.
   • Do not take it with juice or milk.

Do not crush or chew the tablet or allow it to dissolve in your mouth, due to the possibility of ulcers in the mouth.

1. Do not lie down - stay upright (sitting, standing, or walking) - for at least 30 minutes after swallowing the tablet. Do not lie down until after the first meal of the day.

1. Do not take Alendronic Acid/Cholecalciferol Weekly Bluefish at bedtime or before getting up in the morning.

1. If you have difficulty or pain when swallowing, chest pain, or new or worsening heartburn, stop taking Alendronic Acid/Cholecalciferol Weekly Bluefish and inform your doctor.

1. After swallowing a tablet of Alendronic Acid/Cholecalciferol Weekly Bluefish, wait at least 30 minutes before taking the first meal, drink, or other medicine of the day, including antacids, calcium supplements, and vitamins. Alendronic Acid/Cholecalciferol Weekly Bluefish is only effective if taken on an empty stomach.

If you take more Alendronic Acid/Cholecalciferol Weekly Bluefish than you should

If you take too many tablets by mistake, drink a glass of milk and go to the doctor immediately. Do not induce vomiting and do not lie down.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, 91 562 04 20, indicating the medicine and the amount taken.

If you forget to take Alendronic Acid/Cholecalciferol Weekly Bluefish

If you forget a dose, take a single tablet the next morning you remember. Do not take two tablets on the same day. Then take one tablet once a week, on the original day you chose.

If you stop treatment with Alendronic Acid/Cholecalciferol Weekly Bluefish

It is important that you take Alendronic Acid/Cholecalciferol Weekly Bluefish while your doctor prescribes the medicine. As it is not known how long you should take Alendronic Acid/Cholecalciferol Weekly Bluefish, you should discuss with your doctor periodically the need to continue treatment with this medicine to determine if Alendronic Acid/Cholecalciferol Weekly Bluefish is still suitable for you.

A Instructions Card is included in the box of Alendronic Acid/Cholecalciferol Weekly Bluefish. It contains important information to remind you how to take Alendronic Acid/Cholecalciferol Weekly Bluefish correctly.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

Consult your doctor immediately if you experience any of the following adverse effects, which may be serious, and for which you may need urgent medical treatment:

Frequent (may affect up to 1 in 10 people):

• burning; difficulty swallowing; pain when swallowing; ulcer in the throat (esophagus - the tube that connects your mouth to your stomach) that can cause chest pain, burning, or difficulty or pain when swallowing.

Rare (may affect up to 1 in 1,000 people):

• allergic reactions such as hives; swelling of the face, lips, tongue, and/or throat, which can cause difficulty breathing or swallowing; severe skin reactions,
• pain in the mouth, and/or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or tooth loss. These can be signs of damage to the bone in the jaw (osteonecrosis) usually associated with delayed healing and infection, often after a dental extraction. Contact your doctor and dentist if you experience these symptoms,
• atypical fractures of the femur (thigh bone) that can occur rarely, especially in patients undergoing prolonged treatment for osteoporosis. Inform your doctor if you notice pain, weakness, or discomfort in the thigh, hip, or groin, as these may be early symptoms indicative of a possible femur fracture,
• severe bone, muscle, and/or joint pain.

Other adverse effects include

Very frequent (may affect more than 1 in 10 people):

• bone, muscle, and/or joint pain, which may be severe.

Frequent (may affect up to 1 in 10 people):

• swelling of the joints,
• abdominal pain; uncomfortable feeling in the stomach or belching after eating; constipation; feeling of fullness or bloating in the stomach; diarrhea; flatulence,
• hair loss; itching,
• headache; dizziness,
• fatigue; swelling of the hands or feet.

Uncommon (may affect up to 1 in 100 people):

• nausea; vomiting,
• irritation or inflammation of the throat (esophagus - the tube that connects your mouth to your stomach) or stomach,
• black or tar-like stools,
• blurred vision; eye pain or redness,
• skin rash; skin redness,
• transient symptoms, similar to those of the flu, such as muscle pain, general feeling of discomfort, and sometimes fever, which usually appear at the beginning of treatment,
• taste disturbance.

Rare (may affect up to 1 in 1,000 people):

• symptoms of low calcium levels in the blood, including muscle cramps or spasms and/or tingling sensation in the fingers or around the mouth,
• stomach ulcers or peptic ulcers (sometimes severe or with bleeding),
• narrowing of the throat (esophagus - the tube that connects your mouth to your stomach),
• skin rash that worsens with sunlight,
• mouth ulcers.

Very rare (may affect up to 1 in 10,000 people):

• consult your doctor if you experience ear pain, discharge from the ear, or ear infection. These could be symptoms of damage to the bones of the ear.

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Alendronic Acid/Colecalciferol Weekly Bluefish

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date that appears on the blister pack and the carton after CAD. The expiration date is the last day of the month indicated.

Store in the original blister pack to protect it from moisture and light.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE collection point in your pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Alendronic Acid/Colecalciferol Weekly Bluefish

• The active ingredients are alendronic acid and colecalciferol (vitamin D3).

Each tablet contains 70 mg of alendronic acid as alendronate sodium trihydrate and 70 micrograms (2,800 IU) of colecalciferol (vitamin D3).

• The other ingredients are microcrystalline cellulose, lactose, sodium croscarmellose, magnesium stearate, refined sunflower oil, butylhydroxytoluene (BHT)-E321, gelatin, sucrose, corn starch, and aluminum and magnesium silicate.

Appearance of the Product and Package Contents

The Alendronic Acid/Colecalciferol Weekly Bluefish 70 mg/2,800 IU tablets are oblong, white to off-white, biconvex, speckled, engraved with 2,800 on one side, 12.3 ± 0.2 mm in length, and 6.5 ± 0.2 mm in width.

The tablets are supplied in aluminum/aluminum (PA/AL/PVC-aluminum) blisters in a cardboard box in the following package sizes: 4 and 12 tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Bluefish Pharmaceuticals AB,

P.O. Box 49013,

100 28 Stockholm,

Sweden

Manufacturer

Pharmathen International S.A.

Industrial Park Sapes,

Rodopi Prefecture, Block No 5,

Rodopi 69300,

Greece

and/or

Pharmathen S.A.

6, Dervenakion street

Pallini 15351

Attiki,

Greece

and/or

Salutas Pharma GmbH

Otto-von-Guericke Allee 1

Sachsen-Anhalt

39179 Barleben

Germany

You can request more information about this medicine by contacting the local representative of the marketing authorization holder:

Bluefish Pharma S.L.U.,

AP 36007

2832094 Madrid, Sucursal 36

This medicine is authorized in the Member States of the European Economic Area under the following names:

Date of the Last Revision of this Prospectus:August 2022

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/